title: Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report.
abstract: BACKGROUND
  Inguinal lymphadenectomy is the treatment of choice for patients with penile cancer and inguinal lymph node metastases. We describe the performance of the robotic bilateral inguinal lymphadenectomy technique without repositioning the robot in a patient with penile carcinoma and high risk for nodal metastases and no palpable lymph nodes.
  
  
  METHODS
  A 64-year-old male patient was diagnosed with penile cancer (TNM: T3 N 0 M 0) and underwent a total penectomy with perineal urethrostomy. We performed a robotic bilateral inguinal lymphadenectomy four weeks after the penectomy.
  
  
  RESULTS
  The entire procedure was performed with the robot-assisted technique. The operative time, median estimated blood loss, and hospital stay was 360 min, 100 ml (50 ml in the right side and 150 ml in the left side), and three days, respectively. Metastatic nodes were present in both inguinal regions, with a yield of 19 lymph nodes on the right and 14 on the left. The patient presented with a left-side lymphocele that was drained at follow-up. No other complications were reported.
  
  
  CONCLUSIONS
  Robotic bilateral inguinal lymphadenectomy secondary to penile cancer is feasible, safe, and provides a good performance. Prospective studies are required to include a larger number of patients and long-term monitoring to assess the results of this procedure in comparison with open and laparoscopic techniques.
authors.affiliation: Instituto Médico La Floresta, Caracas 1060, Venezuela.
authors.forename: Rene
authors.initials: R
authors.lastname: Sotelo
authors.forename: Marino
authors.initials: M
authors.lastname: Cabrera
authors.forename: Oswaldo
authors.initials: O
authors.lastname: Carmona
authors.forename: Robert
authors.initials: R
authors.lastname: de Andrade
authors.forename: Oscar
authors.initials: O
authors.lastname: Martin
authors.forename: Golena
authors.initials: G
authors.lastname: Fernandez
keywords: lymph nodes; lymphadenectomy; penile cancer; robotic surgery